Visiting Md Ltd | |
2426 N Grandview Blvd Ste D Waukesha WI 53188-6905 | |
(262) 720-7060 | |
(262) 446-3760 |
Full Name | Visiting Md Ltd |
---|---|
Speciality | General Practice |
Location | 2426 N Grandview Blvd Ste D, Waukesha, Wisconsin |
Authorized Official Name and Position | Scott Stollenwerk (OWNER) |
Authorized Official Contact | 2626911000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Visiting Md Ltd 347 Park Ave Pewaukee WI 53072-3413 Ph: (262) 691-1000 | Visiting Md Ltd 2426 N Grandview Blvd Ste D Waukesha WI 53188-6905 Ph: (262) 720-7060 |
NPI Number | 1366724478 |
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Provider Enumeration Date | 09/14/2011 |
Last Update Date | 04/25/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366724478 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
213E00000X | Podiatrist | 681-25 (Wisconsin) | Secondary |
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